The Balance Center

The Balance Center at NWH at Chappaqua Crossing is dedicated to the identification, assessment and treatment of vestibular disorders that can cause symptoms of vertigo, dizziness and imbalance.

What are Vestibular Disorders?

The symptoms most often described by patients include dizziness, vertigo and imbalance. In many cases the cause of these symptoms is in the vestibular system.

Do I Have a Vestibular Disorder?

Take this self-assessment tool on vestibular disorders.

If you answer yes to any of these questions, please consult your physician to discuss whether you should be referred to The Balance Center at Chappaqua Crossings for a Basic Balance Function test.

Do you experience dizziness, vertigo or imbalance?Do you feel dizzy upon getting out of bed?
Are your symptoms spontaneous or provoked by a change in position?

Have you incurred a trauma to the head?This can include a blow to the head, whiplash or a fall.

Have you had/have chronic ear infections?Did you have a sudden hearing loss? Do you experience tinnitus?A change in hearing sensitivity or asymmetric hearing loss should be evaluated.

Have you been diagnosed with Meniere’s disease, Acoustic Neuroma or Mastoiditis?

Were you prescribed high doses or long term use of certain medications including antibiotics?Certain medications can cause permanent damage to the inner ear (hearing mechanism or balance mechanism).

Do your symptoms increase when you walk down aisles or in large open spaces?These can include work spaces, supermarkets or home.

Has your dizziness, vertigo or imbalance interfered with your job or household responsibilities?

Do you suffer from Migraine headaches?Do your symptoms increase with visual stimulation?

Do you suffer from motion sickness?

Did your symptoms begin following a flu or virus?

Dizziness, vertigo and imbalance can be associated with vestibular disorders. Identification of the problem is the first step in helping to alleviate your symptoms. If you are suffering from any of these symptoms and would like to request an appointment, please click here >

What is the vestibular system?

The vestibular system is the portion of the inner ear (inner ear labyrinths) and the brain (the central nervous system) that are responsible for controlling balance and spatial orientation of the body.

The most common vestibular disorders that can affect the vestibular system include:

Benign Paroxysmal Positional Vertigo (BPPV)

Meniere’s disease

Labyrinthitis

Vestibular Neuronitis

Head trauma

Perilymphatic fistula.

In addition there are other less common diagnoses that can affect vestibular function including acoustic neuromas (slow growing tumor), degenerative diseases (Multiple Sclerosis), and autoimmune disorders.

Symptoms

The symptoms of vestibular disorders are often difficult to define as the vestibular system interacts with the nervous system.

Vertigo
The symptom most reported is Vertigo. Vertigo is the perception that the environment is spinning or moving around you. The sensation can last from seconds to minutes and in some vestibular disorders, vertigo can last for hours.

Dizziness
Dizziness is also reported by many people. Dizziness is often associated with unsteadiness, a vague sensation of movement or fuzziness in the head and sometimes a rocking sensation.

Imbalance
Imbalance and unsteadiness are common symptoms. Imbalance is described as difficulty walking without assistance and can result in falls or miss-steps. This is a significant problem for many senior citizens.

Other symptoms include visual disturbances, memory issues, difficulty concentrating and fatigue. Some people will experience headaches, muscles aches, motion sickness, neck or back pain and increased sensitivity to noise and light.

Nausea from mild to severe and from chronic to episodic are also reported to accompany other vestibular symptoms. In some instances vomiting will occur. In addition symptoms including tinnitus, described as a ringing or buzzing in the ear and/or sudden decline in hearing in one or both ears is reported.

Vestibular Assessment

The vestibular system is assessed using a battery of tests to help distinguish between a peripheral vestibular involvement (inner ear) and central nervous system involvement (brain), as well as postural control issues.

Balance Tests

Videonystagmography (VNG/ENG)
This consists of a group of tests that assesses ocular function as well as inner ear function. These tests can show signs of neurological or vestibular disorders. Infrared video goggles are worn to record and analyze eye movements in response to visual stimulus, a change in head or body position and change in temperature in the inner ear. The results of the videonystagmography test will allow for a differential diagnosis.

Rotational Chair
The Rotational Chair evaluates the vestibular system by monitoring eye movements across a broad frequency range. The test is completed while seated in a darkened room. The chair rotates according to specific frequencies for varying times. Results are recorded using small electrodes that are placed around the eyes and forehead.

Computerized Dynamic Posturography
This tests postural stability. The test allows for examination of the relationship between the systems that make up the balance system. It safely allows a patient to stand in a simulated environment that mimics activities they encounter in daily living.

Causes of Vestibular Disorders

There are many situations that can cause vestibular involvement. Some frequent causes include:

Trauma to the head – this can include a blow to the head, whiplash or a fall.

Ear infections and inflammation of the inner ear (labynrinthitis) can result in damage to the vestibular system.

High doses or long term use of certain medications can cause permanent damage to the inner ear (hearing mechanism or balance mechanism). Some drugs or medications can result in temporary vestibular symptoms.

A stroke or reduced blood flow to the can result in vestibular involvement.

Slow growing tumors known as acoustic neuroma, although less common, can lead to vestibular dysfunction

In many cases a weakness in the vestibular system will be identified, however the cause of the weakness will remain unknown.

Steps to Take

If you are experiencing any symptoms of dizziness you should see your doctor.

If you experience a sudden onset of symptoms, seek immediate help.

If you experience a sudden hearing loss you should see an ear specialist (an Otolaryngologist) immediately.

If you experience a sudden onset of vertigo with other accompanying symptoms, seek medical attention.

If dizziness or imbalance are progressively get worse, see a physician again.